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Monday, April 01, 2013

Is Sizzurp Really On The Rise In Canada

'Sizzurp' abuse on the rise


'Sizzurp' abuse on the rise 
TORONTO - They call it "sizzurp," "purple drank" or "water."Cough syrup containing codeine and dextromethorphan are not only being used as a remedy for colds and flus, but are now being taken as a recreational drug.
The cold medications are often mixed with soda and a Jolly Rancher candy to produce the concoction used as an easily-accessible and cheap way to get high.
Since 2010, the U.S. Food and Drug Administration has been looking to curb increased incidents of cough medicine abuse and are considering whether more stringent restrictions could help - noting young people aged 12 to 20 have been more at-risk of using the drugs.
In 2011, dozens of young teenagers and pre-teens in B.C. ended up in the emergency room after overdosing on cold medications.
A Quebec coroner is lobbying the government to relegate dextromethorphan behind the pharmacist's counter after two men in the province died last year because they failed to follow instructions on the label.
And now in Toronto - while drug awareness groups say the number of cough syrup users are low - it's still something to be concerned about.
"It's something that might become a real big issue in a community, but not something that's widespread across the country at any one given time," said Lesley White, executive director of the Council on Drug Abuse (CODA).
"The more factual, non-judgmental information we give to youth, so they know the cost of their actions before they make a decision, the better decisions they'll make."
CODA, a non-profit drug prevention organization, conducted a survey in 2012-13 using 711 students in Grades 7, 8 and 9 in Toronto, Durham and Elliot Lake, and asked them about cough syrup for recreational use. Saskatchewan and Manitoba were part of the survey, but Ontario comprised the brunt of the report.
Of those numbers, 98 kids - 14.1% - knew most of the effects of dextromethorphan abuse.
Roughly 16 kids - 2.5% - said they would "very likely" use the drug in the next 12 months and 40 kids - 6.3% - said it was "likely" they would try syrup.
White said that the culture of syrup has been going on in certain communities, including Toronto and the GTA, for the past seven to nine years.
"If you can keep it out of the hands of youth who have an intent to abuse, you should," she said. "I think there's an overriding attitude that because cough medication is something that's sold in a pharmacy, that it's safer than buying something from a dealer on the street."
Seth Fletcher, a program manager with CODA, said codeine is related to the same opiate family as heroin, morphine and methadone.
"It's a pain reliever, so it blocks a lot of the pain signals from the brain," he said. "It also shares a lot of characteristics with depressant drugs, so it slows your central nervous system down. It gives you that feeling of euphoria. The more you take, the more the high will be. Opiates are one of the most addictive substances - the withdrawal is very hard."
Dextromethorphan (otherwise known as DM or DXM) in high doses, Fletcher said, can lead to that feeling of euphoria, blurred vision, numbness and muscle spasms. It's also been associated with a lot of psychosis, liver damage, hallucinations and anxiety.
Depending on the amount ingested, the effects can last for hours, but it depends on the person's age and weight, Fletcher said.
The culture of drinking "syrup" originated in Texas and is linked to the city's hip-hop culture. DJ Screw, who died in 2000, popularized the drink in the 1990s by remixing tracks and slowing down beats to portray a sound akin to the feeling of being intoxicated from cough syrup.
In a 2009 interview with Katie Couric, rapper Lil Wayne admitted he had been addicted to drinking syrup.
"It's bad because it messes up your stomach," he said in the interview. "Your stomach hurt(s) real, real bad. It's an excruciating pain, but I got through it."
On March 12, Lil Wayne was hospitalized after suffering a seizure, rumoured to be related to "sizzurp," though, he later said he has epilepsy.
Most recently, pop star Justin Bieber was reported by TMZ as holding a bottle of codeine cough syrup at parties.
White fears the celebrity culture will perpetuate syrup use among teens.
"Pop culture has a role in everything when you're talking about youth," she said. "They look to these people as role models and leaders."
Many retailers in the U.S. have moved DXM-containing products behind the pharmacist's counter to be sold to only those over at least 18 years of age. Some stores give out potential abuse fact sheets with the purchase of products containing the active ingredient.
There are numerous websites devoted to syrup users who jot down their experiences while on the drugs. Getting high from dextromethorphan is often dubbed as "robo-tripping" or "tussin" - a play on the Robitussin syrup product.
While the Ontario Ministry of Health and Long-Term Care said syrup overdosing is not an issue for them, it was a concern for the College of Pharmacists of British Columbia when teens overdosed on the drugs on Vancouver Island in 2011.
As a result, the college issued a voluntary ‘put behind the counter' memo to their members for a period of time.
Lori DeCou, who sat on the college's board but has since moved to the Ontario College of Pharmacists, said common sense is key. You can't keep cleaning solutions behind the counter because there's a chance someone can get high off them. Cough syrup is no different.
It's a fine balance," said DeCou. "It would be impractical to have all those behind a pharmacy counter. In the vast majority of times and patients, cold suppressants are used appropriately."
DeCou said she worries media reports about DXM or codeine cough syrup abuse could lead to copycatting.
"We're not aware of any activities like that here in Ontario, but my caution is there is that potential with all kinds of products, and the last thing we would ever want is to help people figure out how to inappropriately figure out how to use anything," she said.
John Yeomans, a University of Toronto professor specializing in lecturing about opiates and drug abuse, said as the Ontario government tightens regulations on prescribing opiates, addicts are turning to alternatives such as cough syrups readily available on shelves.
"When you prevent people from getting one opiate, they then substitute it" with things such as cough syrup, he said.
"All of this effort to remove OxyContin from clinics and from the street, the addicts respond to it by substituting it with other weaker or alternative opiates. It's basically pushing addicts to finding alternatives."
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